1. Field of the Invention
The present invention relates to a manipulator for intraocular surgery and, more particularly, to a multi-function instrument that may advantageously be used during bimanual vitreoretinal surgery. The pick-manipulator of the invention can provide the functions of a vitreoretinal pick, fiberoptic illumination, bipolar diathermy, and irrigation/aspiration of fluids and tissues in a single 19 or 20 gauge instrument.
2. Description of the Related Art
A fiberoptic tissue manipulator is a device used in intraocular surgery to illuminate and to control objects in the surgical field by means of aspiration or irrigation of fluid. Tissue membranes may be peeled, picked up, or aspirated after cutting. Blood and air bubbles can also be cleared from the field by means of suction or irrigation. Aspiration is achieved via a small tube, usually of stainless steel or Kevlar, which can be inserted into the eye. This is connected to an intermediate tube, typically of silicone, to a terminal device such as a syringe or, in the event more advanced control is desired, an automated aspiration control system (such as the Storz Premiere). Light is provided to the surgical field by an illuminating fiber optic. In many conventional devices the fiber optic lies alongside of the aspiration passage in a larger delivery tube. An exemplary fiberoptic manipulator, detailed by McCuen and Hickingbotham in "A fiberoptic diathermy tissue manipulator for use in vitreous surgery", Am J Ophthalmol. 1984; 98; 803-804, also provides bipolar diathermy functions. As is apparent from the foregoing, however, tissue control in known fiberoptic manipulators is limited to aspiration and infusion or irrigation.
During tissue manipulation, it frequently occurs that a pick-like instrument is required to manipulate the tissue, thus requiring that a further instrument be introduced into the surgical field. This requires the manipulation of multiple instruments and/or may require that instruments be temporarily switched. Known pick like instruments, which have no aspiration/infusion capabilities, are exemplified by the fiberoptic pick disclosed in U.S. Pat. No. 4,878,487.